Principal Investigator: Steffani Bailey, PhD

The study examines the implementation of Stage 1 Meaningful Use criteria and identifies facilitators and barriers to assessing and treating smoking in Federally-Qualified Health Centers (FQHCs). This research will inform the development of a primary care-based smoking cessation intervention that utilizes health information technology. It will use quantitative data from OCHIN, a multiple-facility, linked EHR provider, and qualitative data from clinic observations and interviews with health care providers and patients.

Principal Investigator: Timothy Burdick, MD, MS

STOP CRC is a cluster-randomized pragmatic study designed to increase rates of CRC screening in safety-net primary care practices. The overall goal is to increase CRC screening rates in large numbers of diverse patients by devising and testing an intervention that uses a low-cost fecal test. This study is in partnership with 26 FQHC clinics, all of which use the EPIC electronic medical record (EMR) provided by OCHIN. This project promotes the use of fecal immunochemical testing (FIT) for colorectal cancer screening, as it has been shown to be an effective population-based strategy for increasing CRC screening rates.

Principal Investigator: Richard Deyo, MD, MPH

This project will examine patients with chronic pain who do or do not use acupuncture services for their care. It seeks to identify differences that may predispose people to use acupuncture, and differences in outcomes that may result. The project will make use of electronic medical records in the Kaiser Permanente Northwest healthcare system to measure healthcare utilization;a prospective cohort study to measure patient outcomes;and qualitative methods to understand the decision-making process.

Principal Investigator: Richard Deyo, MD, MPH

The overarching goal of this research is to help providers improve the care of complex patients requesting controlled prescription medication. Specifically, the study examines the potential of a statewide prescription monitoring program (PMP) to help providers assess whether a given patient has a legitimate pain need, an addiction, or intent to divert or misuse controlled substances.

Principal Investigator: Richard Deyo, MD, MPH

This supplement complements the initial project, and has three additional goals: 1) develop a metric for the potential risk associated with the prescriptions that a patient is receiving, as a function of time;2) develop a metric for the degree of PDMP usage by prescribers, as a function of time;and 3) analyze the relationship between patient potential prescription risk and prescriber PDMP usage, to test the hypothesis that higher PDMP usage is related to lower patient prescription risk. These metrics would be calculated based on data that has been collected by the Oregon PDMP since its inception in 2011.

Principal Investigator: Richard Deyo, MD, MPH

This proposal will extend work on a multisite randomized trial of epidural steroid injections for lumbar spinal stenosis. It will take advantage of new study sites for recruitment and data collection.

Principal Investigator: Richard Deyo, MD, MPH

This proposal develops methods for studying the implementation of a new strategy for reporting imaging results for the lumbar spine. The plan is to provide epidemiologic data regarding the prevalence of certain findings in normal adults, with the goal of reducing unnecessary patient or primary physician alarm. The ultimate goal is to reduce unnecessary further testing or treatment that may result from misunderstanding of the imaging results.

Principal Investigator: Richard Deyo, MD, MPH

The aims of this research are: 1) Conducting a cluster (clinic) randomized pragmatic clinical trial in 40 primary care clinics across the three KP health plan settings (Hawaii, Northwest, Georgia) to compare the effects of the multidisciplinary biopsychosocial intervention to usual care on patients' pain symptoms, pain-related functioning, and satisfaction with health care services;patients' use of health care services including receipt of opiate medication, and the cost of the program and economic impact of the intervention. As cost considerations will be important for the translatability of this project, articulating the cost impact for health plans will be an important aspect of the dissemination. 2) Conducting process and implementation evaluations to understand, describe, explain, and enhance intervention Reach (to diverse patients), Effectiveness, Adoption, Implementation, and Maintenance. 3) Creating, refining, and disseminating an implementation guide for the collaborative care pain intervention based on findings from Aims 1 &2 and perspectives from key informant interviews of administrators and staff at federally funded safety net clinics that may serve as future dissemination-implementation sites.

Principal Investigator: Melinda Davis, PhD

The overarching goal of this application is to refine and evaluate a "PCOR Coaching Model" to support CEnR on health and health systems in rural settings. The goals for this study are: 1) conduct a systematic review of approaches and evaluation strategies for engaging rural populations in the conduct and translation of research;2) develop a pragmatic, rapid cycle "PCOR Coaching Model" to strengthen the implementation and evaluation of regional CCO transformation initiatives;and 3) examine community-based partner knowledge, confidence, and trust in collaborative research partnerships following implementation of the PCOR Coaching Model.

The rationale for this project is that these risk factors can be prospectively utilized in the form of a prediction rule to guide prudent empiric antibiotic selection and thereby reduce the evolutionary selective pressures that lead to increased multi-drug resistant bacteria.  Two specific aims will be pursued: 1) Develop and validate a prediction rule to guide empiric antibiotic prescribing in adult female patients with uncomplicated urinary tract infection by identifying patients at higher risk of infection due to TMP/SMX-resistant Enterobacteriaceae and 2) Establish the feasibility of clinical use of the prediction rule by assessing prospectively evaluating patient safety and scientific validity.

Principal Investigator: Patty Carney, PhD

To evaluate the accuracy of dermatopathology interpretation, emphasizing the classification of atypical and malignant lesions, where previous studies reveal a concerning degree of diagnostic errors.

Principal Investigator: Miguel Marino, PhD

This project evaluates an innovative workplace intervention designed to reduce work-family conflict on the health, particularly cardio metabolic and sleep health, of direct patient-care employees in the long-term health care industry. This intervention is designed to decrease work-family conflict for employees, but has the potential of increasing the organizational support for the work-family needs of mid-level managers - those supervisors in the trenches who deal with the day-to-day work life and supervision of employees - leading to improved health of these managers.

Principal Investigator: Richard Deyo, MD, MPH

The proposed aims include augmenting Spine Surgical Care and Outcomes Assessment Program (Spine SCOAP) data with the addition of surveys related to personality traits, mental health and relationships, and adding standardized evaluations of preoperative radiographic images used in the course of clinical care. Specifically, among patients with degenerative disc disease (DDD) undergoing fusion, aims are to determine patient characteristics associated with non-response and determine radiographic features at baseline that are associated with non-response.  The findings of this study will ultimately be used to develop predictive models that can be efficiently tested across Washington State hospitals.